Dr Ken Clark The challenge of addressing bullying, sexual harassment and other inappropriate behaviour in the medical profession Chief Medical Officer, MidCentral DHB Chair, National CMOs’ Group

Dr Jones is a first year registrar in Internal Medicine. She comes to you as an SMO she feels she can talk to – she is clearly upset and indicates that one of your colleague consultants has been threatening her with poor grades on her assessment and has been setting her unreasonable work tasks.

What are you going to do?

Last year another registrar left early and on exit indicated to you that he felt he had been bullied by this same SMO – he reported that the consultant had ‘ranted and raved’ about any errors the doctor had made and would make disparaging remarks about the registrar to his colleagues, even when the RMO was present.

What are you going to do?

What is bullying? What is harassment?

Bullying “To threaten, oppress or tease, either physically or morally, and can include: Public humiliation, persistent criticism, personal insult, professionally undermining a person’s professional ability, consistently undervaluing effort and abuse of power” (RACS 2014)

Harassment “The act of tormenting by persistent attacks and criticism” “The act of making unwelcome intrusions upon another” (Merriam-Webster)

What I’m not going to talk about…

Is there really an issue?

RDA surveys 600 RMOs have experienced and/or witnessed sexual harassment, bullying or inappropriate behaviour in last two years Perpetrators – 435 SMOs, 161 Nurses ‘Rite of passage’ Fear of career blocking Even if did report not a lot would happen

10% of RMOs have personally experienced and or witnessed sexual harassment in the last two years 47% of RMOs have personally experienced and or witnessed bullying in the last two years 43% of RMOs have personally experienced and or witnessed inappropriate behaviour in the last two years

RACS Report / Expert Advisory Group Findings

NZMSA / Medical Schools / NZMJ…

CMO experience The tip of the iceberg?

Reactions from the profession - The high ground, the middle ground and the low ground?!

“How can I feed back to a doctor in training about poor performance or poor suitability for our specialty if any negative communication is then perceived as bullying?”

“This isn’t just a medical thing – look at Law and the other professions. This generation is incredibly lucky and need to get to grips with the real world, with earning a living (a good one at that), and with performing at a high level day after day.”

“It’s a disgrace. The surgeons have been doing it for too long and have dragged the whole profession down.”

Is it any more a problem in 2015 than it was in years past?

It doesn’t matter

What are we going to do about it?

Current publicity Ownership

Resource within the profession and from without

Codes / Statements / Practice guidelines HR policies and procedures External resources

National working group (specifically Medical) Key strategies - ‘Tool kit’ - Empowering bystanders - Leadership – training, capability, courage - Accountability

Tough calls Leadership Professionalism Persistence

You are on a teaching ward round with two teams involved. Your senior colleague interrogates his house officer, patient after patient, until the RMO can barely respond and is visibly upset….

What are you going to do?

Let’s talk about it!

Donations to Canterbury Charity Hospital Trust A collection box will be circulating the room

Dr Ken Clark The challenge of addressing bullying, sexual harassment and other inappropriate behaviour in the medical profession Chief Medical Officer, MidCentral DHB Chair, National CMOs’ Group